MSA Compliance and Medical Review Specialist

Founded in 1939 as a small, two-partner firm, Brown & Brown (NYSE: BRO) and our team of companies have grown into one of the world’s largest insurance brokerages while staying true to our foundation of trust, resilience, and delivering results. With a team that is as connected locally as it is globally, our high-performing, highly collaborative team delivers innovative risk and insurance solutions. We look for individuals who embrace our culture, thrive in a collaborative environment, are driven to grow and succeed, and are committed to always doing what is right. With a unique culture built on integrity, superior capabilities and grit, we value teamwork, trust and courage. We think of ourselves as a team, so we have teammates—not employees, and leaders—not managers. Everything we do is about the greater “WE”—never “me.” While diverse in abilities and experience, we are all connected through our core values, a commitment to our local communities and a shared mission—always doing what is best for our customers.

Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Summary: Prepares future medical cost projections and Medicare Set-aside Allocation reports. Interacts regularly with customers providing excellent customer service. Communicates daily with internal teams at IMPAXX.

Reviews and analyzes medical records, claim file documents, hearing orders, and depositions for preparation of allocation reports. Researches Medicare coverage, jurisdictional, and regulatory guidelines. Communicates frequently and effectively with Team Leader, Coding Team, Clinical Director, and Referral Coordinators. Reviews resources on the Analyst iPortal and IMPAXX Intranet frequently, including customer handling instructions. Ensures thorough and accurate file documentation including data entered into MyConnect. Prepares future medical cost projections and Medicare Set-aside Allocation reports. Responsible for data entry into the medical tab for development of allocation preparation. Communicates with customer as needed for clarification of outstanding information needed to complete the allocation report requested. Provides rationale for allocation and identify mitigation opportunities. Reviews auto-MyConnect pricing function to ensure accuracy. Proofreads both calculation and summary generated. Provides feedback for possible improvements to workflow processes within the MyConnect system. Delivery of allocation report to customer identifying exposure and mitigation opportunities. Responds to direct inquiries from customer regarding delivered allocations or other MSP compliance questions from customer or facilitate the direction to the appropriate team. Reviews, analyzes, and communicates CMS counter opinions as assigned. Produce a minimum of 1.2 allocation reports per day based on a fiscal month end average. Maintains confidentiality and security of all medical records received and reviewed Any other duties as may be assigned.